Inhibitory effect of cranberry extract on periodontopathogenic biofilm: An integrative review

Effect of a multinutrient supplement as an adjunct to nonsurgical treatment of periodontitis: A randomized placebo-controlled clinical trial

BACKGROUND

The aim of this double-blind randomized placebo-controlled clinical trial was to evaluate the efficacy of a multinutrient supplement as an add-on therapy to scaling and root planing for patients with periodontitis.

METHODS

Forty-two patients with stage III or IV periodontitis were randomly allocated to a 2-month treatment of either a multinutrient supplement containing vitamin C, vitamin E, zinc, selenium, alpha-lipoic-acid, cranberry extract, grapeseed extract, and coenzyme Q10 or placebo capsules as an adjunct to conservative periodontal therapy. Periodontal parameters, including probing pocket depth, gingival recession, bleeding on probing, approximal plaque index, and papillary bleeding index, were assessed. Clinical attachment loss, periodontal inflamed surface area, periodontal epithelial surface area, and percentages of pocket sites with ≤3, ≤4, ≥5, ≥6, ≥7, and ≥4 mm with bleeding on probing were calculated.

RESULTS

All clinical parameters significantly improved from baseline to reevaluation within each group (p < 0.05). Multinutrient intake resulted in a significantly higher reduction of probing-pocket-depth (-0.75 ± 0.42 mm) and bleeding-on-probing (-21.9 ± 16.1%) from baseline to reevaluation compared with placebo (-0.51 ± 0.30 mm, p = 0.040 and -12.5 ± 9.8%, p = 0.046, respectively). All periodontal parameters showed insignificantly higher improvements in patients receiving the supplement compared with those receiving the placebo (p > 0.05).

CONCLUSIONS

Multinutrient supplementation as an adjunct to nonsurgical treatment of periodontitis showed some additional benefit regarding probing-pocket-depth and bleeding-on-probing. However, the clinical relevance needs to be further explored.

Advances in novel therapeutic approaches for periodontal diseases

Periodontal diseases are pathological processes resulting from infections and inflammation affecting the periodontium or the tissue surrounding and supporting the teeth. Pathogenic bacteria living in complex biofilms initiate and perpetuate this disease in susceptible hosts. In some cases, broad-spectrum antibiotic therapy has been a treatment of choice to control bacterial infection. However, increasing antibiotic resistance among periodontal pathogens has become a significant challenge when treating periodontal diseases. Thanks to the improved understanding of the pathogenesis of periodontal disease, which involves the host immune response, and the importance of the human microbiome, the primary goal of periodontal therapy has shifted, in recent years, to the restoration of homeostasis in oral microbiota and its harmonious balance with the host periodontal tissues. This shift in therapeutic goals and the drug resistance challenge call for alternative approaches to antibiotic therapy that indiscriminately eliminate harmful or beneficial bacteria. In this review, we summarize the recent advancement of alternative methods and new compounds that offer promising potential for the treatment and prevention of periodontal disease. Agents that target biofilm formation, bacterial quorum-sensing systems and other virulence factors have been reviewed. New and exciting microbiome approaches, such as oral microbiota replacement therapy and probiotic therapy for periodontal disease, are also discussed.

The Effects of Nutraceuticals and Bioactive Natural Compounds on Chronic Periodontitis: A Clinical Review

The paper aims to review the current clinical evidence of various herbal agents as an adjunct treatment in the management of chronic periodontitis patients. Gingivitis and periodontitis are two common infectious inflammatory diseases of the supporting tissues of the teeth and have a multifactorial etiology. An important concern about chronic periodontitis is its association with certain systemic disease. New treatment strategies for controlling the adverse effects of chronic periodontitis have been extensively assessed and practiced in sub-clinical and clinical studies. It has been shown that the phytochemical agents have various therapeutic properties such as anti-inflammatory and antibacterial effects which can be beneficial for the treatment of periodontitis. The findings of this review support the adjunctive use of herbal agents in the management of chronic periodontitis. Heterogeneity and limited data may reduce the impact of these conclusions. Future long-term randomized controlled trials evaluating the clinical efficacy of adjunctive herbal therapy to scaling and root planing are needed.

The effect of cranberry juice and a cranberry functional beverage on the growth and metabolic activity of selected oral bacteria

BACKGROUND

The oral microbiota is a significant risk indicator for oral diseases, such as dental caries and periodontal inflammation. Much attention is presently paid to the development of functional foods (e.g. beverages containing cranberry constituents, or foods containing probiotics) that may serve as adjuncts for oral disease treatments (e.g. periodontitis and caries). Cranberry fruit, due to its unique chemical composition and antimicrobial potential, is a possible ingredient of such foods. The study aimed to investigate the effects of cranberry juice (CJ) and a cranberry functional beverage (mixture of 80% v/v apple juice, 20% v/v cranberry juice, and 0.25 g/100 mL ground cinnamon; CFB) on the growth and metabolic activity of selected oral bacteria.

METHODS

Serial dilution pour plate method (SDPP) was used to examine the effect of CJ and CFB on the growth of Actinomyces naeslundii, Streptococcus mutans, and Lactobacillus paracasei subsp. paracasei. 48-h electrical impedance measurements (EIM) during the cultivation of A. naeslundii were applied to evaluate the utility of the method as a rapid alternative for the assessment of the antimicrobial potential of cranberry beverages.

RESULTS

The tested bacteria differed in their susceptibility to the antimicrobial action of CJ and CFB, with L. paracasei subsp. paracasei being least vulnerable to CFB (according to SDPP). Although CJ at a concentration of 0.5 mL/mL, showed a bactericidal effect on the growth of S. mutans, A. naeslundii was more sensitive to CJ (SDPP). Its inhibitory effect on A. naeslundii was seen even at concentrations as small as 0.03125-0.125 mL/mL (SDPP and EIM). On the other hand, S. mutans seemed to be more vulnerable to CFB than A. naeslundii (SDPP).

CONCLUSIONS

CFB may be considered an adjunct in the treatment of oral diseases due to its action against selected oral pathogens, and not against the presumably beneficial L. paracasei subsp. paracasei. Bioelectrical impedance measurements appear to be a quick alternative to evaluating the antimicrobial activity of fruit beverages, but their utility should be confirmed with tests on other bacteria.